Monday, August 30, 2010

Medicine Meets Music History: What Killed Mozart?

On November 20th 1791 Wolfgang Amadeus Mozart became bed bound. He began to have swelling in his hands and feet. He became listless and began to have fever and vomiting. On December 4th, a group of friends came to perform parts of the Requiem for him. His condition worsened through the night. On December 5th Mozart died at age 35. (Sounds like an episode of House.) He was officially diagnosed by his physician as having had miliary fever (which is apparently a catch all diagnosis for a fever with a rash). His body was buried in a common grave. Soon after his death the speculation as to the exact cause began. A recent New York Times article delves into the medical mystery surrounding the death of Mozart. (The painting is “Mozart 1756-91 Sings His Requiem,” painted in 1882 by Thomas W. Shields.)

The New York Times article discusses an article published in Medical Problems of Performing Artists. They summarized the known theories and came up with 118 different ones. Mozart himself once thought he had been poisoned, so that has been one theory. Others include renal failure from various causes, bacterial endocarditis, and congestive heart failure. Medical malpractice even enters the picture. While Mozart was on his death bed, his physician was sent for at the theatre. He apparently responded that he would be there after the show. (The painting to the left is Hermann Kaulbach's 1872 oil painting "Mozart's last days".)

If you're hungry for more information on this medical mystery, you'll be pleased. A quick Google search revealed a Wikipedia page, an article in the Annals of Internal Medicine, and a Medscape article to name a few. I had no idea there was so much interest in this topic.

To me the bigger question is not what actually killed Mozart, but why so many people care so much. A lot of people have spent a lot of time trying to figure this out. One theory given by the article is that a large proportion of doctors play musical instruments. (Really? They don't cite any studies on this, just mention one doctor who does. Very scientific.) From the article: "The very idea that remarkable individuals who gave life so much beauty could be brought down by ordinary physical ailments, particularly diseases that are now easily treatable, is inherently fascinating. That perception makes people of genius seem closer to us."

I don't really agree that doctors are interested because they play musical instruments and want to feel closer to genius. I think it is more likely that many doctors and others of the medical community like a good mystery. (I met a doctor once who did years of extensive research on the assassination of JFK.) And this is a good medical mystery with actually quite a few first hand accounts that one can sink ones teeth into. We can guess all we want, but given the age of the mystery and the fact that there is no available body, it seems there will never be an answer. Maybe that's really why the medical community enjoys researching this. If we can never solve the mystery for sure, then you can't be wrong.

Monday, August 30, 2010 by Amber Wollesen, MD · 2

Monday, August 23, 2010

The Tombeau

The Tombeau is a musical form from the 16th and 17th century which was a type of musical eulogy for notable individuals. The composition style is known as the tombeau, which in French literally means "tomb" or "grave".

These pieces were written primarily for one instrument, and most commonly were played on a lute. The style developed in France, and was different than the Italian lamento, which was more overtly emotional.

There were however, clear symbolic elements of death represented in the tombeau. For instance, repeated note motifs to indicate death knocking on the door and descending or ascending scales to represent the soul's journey. The harmonies were often in minor modes and played slowly for the effect of mourning.

Most of the works are in honor of someone. The first piece below entitled "Tombeau sur la mort de Monseigneur Comte de Logy" (Tombeau on the death of Count de Logy), was written by Sylvius Leoplod Weiss in 1721 to honor Jan Antnonin Losy, who was the Count de Logy.

Count Logy, pictured to the left, was born in 1650, and though a Bohemian aristocrat was actually an accomplished lutenist as well. He played with some of the more well known lute players of the time. The count died at age 71 of "dropsy", which was the historic term for edema. As was fitting, another lutenist, in fact one of the most important lutenists in history, S. Weiss wrote a piece commemorating Count Logy.

For an example of a more personal tombeau, listen to the 2nd piece below,"Tombeau de M. Blancheroche" by J.J. Froberger. Froberger was a well known composer living in Paris in 1652. He and fellow lutenist Charles Fleury, known by the name Blancrocher, were out on the town when Blancrocher in an intoxicated state stumbled down some stairs and died in Froberger's arms. Interestingly, a typical tombeau ends in an upward scale, implying the soul headed to heaven, however, Froberger ends his tribute to his friend ominously with a downward scale, as it was known that a priest was unable to administer Last Rites before Blancrocher died.

Blancrocher must have been well known or well liked, as there were a total of 4 tombeaux written in his honor by all the who's who's of lutenists of the time.

Is the tombeau still around? It actually is, I found several examples of tombeux in the modern era, such as Michael Daugherty's Le Tombeau de Liberace (1996), and Tombeau de Carol Lombard by Otto Henry.

Below, courtesy of YouTube, are examples of the two 16th century pieces discussed above.

Monday, August 23, 2010 by Amy Clarkson · 2

Monday, August 16, 2010

My Least Favorite Funeral Songs

So first a disclaimer. This is entirely my opinion. It is possible that someone may very well think that my least favorite funeral songs are their favorites. (I would love to hear which ones you like/dislike and why.) We have several times done lists of top movies and music we liked, so I figured I would hit on a list of dislikes.

When I was trying to think of why I liked some songs at funerals and not others, there are a few elements of the songs that seemed to sway me. 1. Do I actually like the song (of course)? 2. What is the intent of the song? 3. What thoughts does this song conjure up when I hear it?

These are songs that I have actually heard at funerals. So, in no particular order:

Somewhere Over the Rainbow-I actually do like this song as far as songs go. I don't think it is too emotionally heavy. My issue with it is that every time I hear it I think of Dorothy and the Wicked Witch. And then the next song that pops into my head is... Ding Dong the Witch is Dead. I've heard it at funerals a couple times and it just doesn't put me in a very funeral mindset.

Memory-I don't particularly like this song, but I dislike it for funerals for a similar reason as the above. Every time I hear it I think of dancing people dressed up as cats. Again, weird mindset for a funeral.

Holes in the Floor of Heaven by Steve Wariner-First I'm not a huge country fan but that is not why I don't care for this one. I put this in a group of songs that I consider to be emotional torture. They are the songs that you just know you will get people crying with. If the purpose of a song is to make people more sad and crying, why would you play it at a funeral where people are already sad and crying. (Again, completely my opinion.) If I'm going to cry at a funeral I think it should be for the person who has died, not for the manipulative song.

But in the end, it doesn't really matter what I or anyone else thinks. Writing this post, I looked through a lot of lists of music that are put out as suggestions for funeral songs. Disturbingly, the song my husband and I danced to at our wedding was on a list (Never Tear Us Apart by INXS). I think this just shows that songs take on different meanings to different people. If it gives you peace to play Another Bites the Dust at a loved ones funeral, then I think you should.

Monday, August 16, 2010 by Amber Wollesen, MD · 14

Monday, August 9, 2010

PNG Mourning traditions

I just recently returned from a trip to Papua New Guinea. It is one of my favorite places on earth, and each time I go I encounter something new.

On this trip, as I was leaving the Western Highlands Provence city of Mt. Hagen, I intercepted with a large clan awaiting the return of the body of one of their "bikpela" men (well educated, well respected man).

Truck load after truck load packed full of clan members tumbled into the airport parking lot to await the body being flown in from the capital.

Everyone was covered in orange clay, faces and hands thick. They had also painted all their trucks and cars in the entourage with clay hand prints and the deceased's name with the
words "welcome home".

As I stood on the periphery an eerie song started, a mourning song half sung and half cried. Other woman took the role of mourner by wailing loudly. The process went on for nearly an hour until the plane landed. I had a recorder with me and below is a 30 sec. snippet of their singing/mourning.

Taking some time to research this practice, I realized that painting the body with clay is something practiced all over the globe. Ancient Egyptians, Australian aborigines, many North American Indians and African groups are all among those who paint clay on themselves to mourn. They often leave the clay on for a prescribed amount of time as an outward sign of a the mourning period.

The idea of physically altering one's appearance to denote mourning occurs in many different ways. Historically, in the Jewish tradition, ashes and sackcloths were used and in ancient Rome, a black toga was worn. In the Hindu tradition, usually pure white will be worn in the mourning period and in the US and Europe in the 1800's people used to wear black dresses and suits for a certain length of time.

There are some noted extremes of a more permanent nature. In PNG as well as other cultures, individuals will in fact amputate a distal part of their finger as an eternal reminder of that person's loss. I saw many people during my trip with missing joints of their pinkie finger or first finger. I was told that in some clans there is a significance to which finger is amputated, i.e the loss of one's child vs the loss of a parent.

Historically and continually many cultures have outward displays of their grief. While we set aside time in the US for a funeral, I wonder if there is something lost without any lengthy period of outward display?

Below is the recording I took - note the song, but also the wailers in the background.

Monday, August 9, 2010 by Amy Clarkson · 0

Monday, August 2, 2010

Penn & Teller "Old People"

Penn & Teller: B.S! is a Showtime documentary series. Magicians/comedians Penn and Teller set out, in a comedic way, to debunk various paranormal and pseudoscientific beliefs and common myths. Some of their topics have been ESP, astrology, lie detectors, and organic food. One of the most recent episodes, "Old People", takes on various myths and stereotypes faced by the elderly. It isn't meant to offend (something the show definitely doesn't mind doing), but rather point out how disrespectful American culture is of the elderly.

Myth: There is an "old person smell". They set up an experiment with 3 old and 3 young people and had blindfolded volunteers smell them. The smellers had to determine if the smellee was old or young. They were accurate only 56% of the time. Very scientific evidence against the "old person smell".

Myth: Older people can't drive (or drive poorly or slowly). They featured a 70 year old race car driver. They also pointed out that those in the age group 16-24 are more likely to cause a fatal accidental.

Myth: The elderly don't have sex. They interviewed several members of a retirement community about their active sex lives.

But in the end the show takes a serious turn. The last section deals with a controversial end of life issue, physician assisted suicide, or as they call it aid in dying (pointedly to take the word suicide out of the name). They interviewed a gentleman, Sheldon, with mesothelioma, who wants to be able to end his life when things become intolerable. Despite the fact that Penn and Teller clearly are in favor of aid in dying, they do give some screen time to a doctor who disagrees with them. And they didn't taunt him, much. They specifically recognize that it is complex issue, not just black and white.

One of their guests sums it up nicely at the end. "For us just to sort of say, 'Old people have come and gone. Let's sweep them under the rug,' it would be a terrible mistake of ours as a culture, as human beings. I think its unfair to deny them their essential humanity just because they've lived longer than us. That's insane." I know that in a blog frequented by hospice and palliative care professionals, this is preaching to the choir. But I do think it was an interesting topic for them to take on.

Monday, August 2, 2010 by Amber Wollesen, MD · 0